The recently developed scheduled mobile-telephone referral model (DETELPROG) has achieved especially important results in reducing waiting days for patients, but it has been decided to explore what barriers and positive aspects were detected by both primary care physicians (PCPs) and hospital attending physicians (HAPs) regarding its use. For this, a qualitative descriptive study was carried…
Todavía son escasas las publicaciones que analizan los efectos en migrantes o minorías étnicas de la COVID-19 o de las medidas adoptadas para frenar la pandemia, si bien los primeros estudios apuntan a un mayor impacto en poblaciones negras, asiáticas y de minorías étnicas en Reino Unido o en migrantes en México. Además de en…
Continuous exposure to low doses of persistent organic pollutant (POPs), such as those occurring in the general population, might contribute to the burden of type 2 diabetes mellitus (T2DM). However, evidences from longitudinal studies are scarce. We aimed to explore the associations of accumulated POP exposure with the development of T2DM by means of 1)…
Aim : To evaluate the effect of different communication strategies on comprehension and recall of information about factors associated to peri‐implantitis. Material and methods : A prospective, randomized controlled trial was conducted in consecutive patients diagnosed with peri‐implantitis. The sample was divided into three groups according to the communication strategy used: Test group1 – Written communication…
Background Perfluoroalkyl substances (PFASs) have been related to neurodevelopmental toxicity in animals. However, human studies are inconclusive. Objectives To evaluate the association between prenatal PFAS exposure and neuropsychological development during childhood. Methods 1240 mother–child pairs from the Spanish INMA Project were analyzed. Perfluorohexanesulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), and perfluorononanoic acid (PFNA)…
Epidemiologic studies examining the association between specific fatty acids and colorectal cancer (CRC) risk are inconclusive. We investigated the association between dietary estimates and plasma levels of individual and total saturated (SFA), monounsaturated (MUFA), industrial‐processed trans (iTFA), and ruminant‐sourced trans (rTFA) fatty acids, and CRC risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Baseline fatty acid…
Objetivo Analizar el lenguaje y el contenido del cuestionario utilizado en la Encuesta de Fecundidad 2018 en España, desde una perspectiva de género. Método Diseño cualitativo basado en el análisis de contenido del cuestionario empleado en la Encuesta de Fecundidad 2018, utilizando recomendaciones y guías metodológicas para estadísticas con perspectiva de género y la comparación…
Background Patient access to orphan medicinal products (OMPs) is limited and varies between countries, reimbursement decisions on OMPs are complex, and there is a need for more transparent processes to know which criteria should be considered to inform these decisions. This study aimed to determine the most relevant criteria for the reimbursement of OMPs in…
BACKGROUND & AIMS Evidence regarding the association of dietary exposures with colorectal cancer (CRC) risk is not consistent with a few exceptions. Therefore, we conducted a diet-wide association study (DWAS) in the European Prospective Investigation into Cancer and Nutrition (EPIC) to evaluate the associations between several dietary exposures with CRC risk. METHODS The association of…
Breast cancer is one of the most frequent malignancies. The aim of the article is to analyse the cost-utility ratio and budgetary impact of talazoparib treatment for patients with locally advanced or metastatic gBRCA + breast cancer from the perspective of the Spanish National Health System. Analyses were based on the EMBRACA clinical trial and the model was constructed…
Background: The global health emergency generated by the COVID-19 pandemic is posing an unprecedented challenge to healthcare workers (HCWs), who are facing heavy workloads under psychologically difficult situations. Objective: This trial aims to evaluate the effectiveness of a psychoeducational mobile Health (mHealth) intervention to reduce mental health problems in HCWs during the COVID-19 pandemic. Methods:…
Background The patient interval—the time patients wait before consulting their physician after noticing cancer symptoms—contributes to diagnostic delays. We compared anticipated help-seeking times for cancer symptoms and perceived barriers to help-seeking before and after the coronavirus pandemic. Methods Two waves (pre-Coronavirus: February 2020, N = 3269; and post-Coronavirus: August 2020, N = 1500) of the Spanish Onco-barometer population survey were compared.…
Background: Renal cell carcinoma (RCC) accounts for more than 80% of kidney cancers in adults and obesity is a known risk factor. Regular consumption of sweetened beverages has been linked to obesity and several chronic diseases including some types of cancer. It is uncertain whether soft drink and juice consumption is associated with risk of…
Background Vitamin B6 insufficiency has been linked to increased risk of cancer and other chronic diseases. The circulating concentration of pyridoxal 5′-phosphate (PLP) is a commonly used measure of vitamin B6 status. Ratios of substrates indicating PLP coenzymatic function and metabolism may be useful complementary measures to further explore the role of vitamin B6 in…
Healthcare professionals (HCPs) often suffer high levels of depression, stress, anxiety and burnout. Our main study aimswereto estimate the prevalences of poor self-perceived health, life dissatisfaction, chronic disease and unhealthy habits among HCPs and to explore the use of machine learning classification algorithms to remove selection bias. A sample of Spanish HCPs was asked to…
Background Trans fatty acids (TFAs) have been hypothesised to influence breast cancer risk. However, relatively few prospective studies have examined this relationship, and well-powered analyses according to hormone receptor-defined molecular subtypes, menopausal status, and body size have rarely been conducted. Methods In the European Prospective Investigation into Cancer and Nutrition (EPIC), we investigated the associations…
Identification of causal factors that influence fetal growth and anthropometry at birth is of great importance as they provide information about increased risk of disease throughout life. The association between maternal genetic polymorphism MTHFR(677)C>T and anthropometry at birth has been widely studied because of its key role in the one-carbon cycle. MTHFR(677) CT and TT…
Advanced glycation end-products (AGEs) are a heterogeneous group of compounds formed by the non-enzymatic reaction between amino-acids and reducing sugars, or dicarbonyls as intermediate compounds. Experimental studies suggest that AGEs may promote colorectal cancer, but prospective epidemiologic studies are inconclusive. We conducted a case-control study nested within a large European cohort. Plasma concentrations of three…
We explored the role of socioeconomic inequalities in COVID-19 incidence among cancer patients during the first wave of the pandemic. We conducted a case-control study within the UK Biobank cohort linked to the COVID-19 tests results available from 16 March 2020 until 23 August 2020. The main exposure variable was socioeconomic status, assessed using the…
Fundamentos: Los mayores institucionalizados han sido el grupo más afectado por la pandemia de COVID-19. El objetivo del presente estudio fue describir las principales características epidemiológicas de un brote de COVID-19, detectado en marzo 2020 en una residencia para mayores de Granada, e identificar los factores de riesgo asociados a la propagación del virus en…
Ataxia in children is a common clinical sign of numerous neurological disorders consisting of impaired coordination of voluntary muscle movement. Its most common form, cerebellar ataxia, describes a heterogeneous array of neurologic conditions with uncountable causes broadly divided as acquired or genetic. Numerous genetic disorders are associated with chronic progressive ataxia, which complicates clinical management,…
Background Population-based cancer registries are required to calculate cancer incidence in a geographical area, and several methods have been developed to obtain estimations of cancer incidence in areas not covered by a cancer registry. However, an extended analysis of those methods in order to confirm their validity is still needed. Methods We assessed the validity…
Background: DESDE-LTC (Description and Evaluation of Services and DirectoriEs for Long-Term Care) is an international classification system that allows standardized coding and comparisons between different territories and care sectors, such as health and social care, in defined geographic areas. We adapted DESDE-LTC into a computer tool (DESDE-AND) for compiling a directory of care services in…
La diabetes mellitus (DM) es una enfermedad compleja y multifactorial que requiere un proceso integrado de actividades y diferentes niveles de medición de resultados1. El cuidado transdisciplinario (CTD) es la prestación conjunta que asocia diferentes entornos y disciplinas con interacciones continuas entre el sistema de salud y social en los que cada persona está inmersa…
The liver plays a prominent role in maintenance of homeostasis and is the major organ for xenobiotic metabolism, including pesticides. Conventional liver function tests are widely used to assess hepatocellular and biliary system dysfunction by measuring serum levels of aminotransferases (ALT, AST) and cholestasis enzymes (alkaline phosphatase –ALP– and γ-glutamyl transferase –GGT–), respectively. Although these…
La violencia sexual, incluyendo las agresiones sexuales facilitadas por drogas, es un serio problema cada vez más común en los contextos de ocio nocturno. Este trabajo estudia las actitudes y percepciones de la juventud española en torno a la violencia sexual en dicho ámbito. Los participantes se reclutaron mediante muestreo en bola de nieve. Se…
In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and…
To evaluate the impact of a psychoeducational, mobile health intervention based on cognitive behavioural therapy and mindfulness‐based approaches on the mental health of healthcare workers at the frontline against COVID‐19 in Spain. Design We will carry out a two‐week, individually randomized, parallel group, controlled trial. Participants will be individually randomized to receive the PsyCovidApp intervention…
Background: Observational evidence has shown that smoking is a risk factor for breast and colorectal cancer. We used Mendelian randomization (MR) to examine causal associations between smoking and risks of breast and colorectal cancer. Methods: Genome-wide association study summary data were used to identify genetic variants associated with lifetime amount of smoking (n=126 variants) and…
In Latin America, ‘judicialization’ for access to healthcare refers to thousands of different claims, conditions, technologies and circumstances. Its impact depends on what is ‘judicialized’, why, for which benefit, and at what cost to society. Since judges cannot, by themselves, reduce medical uncertainty – or price tags – their health systems are exposed to costly…
Background The management regarding metastatic colorectal cancer throughout Europe is not well known. Aims To draw a European comparison of the management and prognosis of metastatic colorectal cancers. Methods Factors associated with chemotherapy administration were identified through logistic regressions. Net survival was estimated and crude probabilities of death related to cancer and other causes using…
Background: A growing body of evidence suggests that alterations of dietary fatty acid (FA) profiles are associated with colorectal cancer (CRC) risk. However, data from large-scale epidemiological studies using circulating FA measurements to objectively assess individual FA and FA categories are scarce. Methods: To investigate the association between red blood cell (RBC) membrane FAs and…
Aims Physical and psychiatric comorbidities are common in cancer patients and could impact their treatment and prognosis. However, the evidence base regarding the influence of comorbidities in the management and health service use of patients is still scant. In this research we investigated how physical comorbidities are related to the mental health and help‐seeking of…
Alcohol consumption is causally linked to several cancers but the evidence for stomach cancer is inconclusive. In our study, the association between long‐term alcohol intake and risk of stomach cancer and its subtypes was evaluated. We performed a pooled analysis of data collected at baseline from 491 714 participants in the European Prospective Investigation into Cancer…
Environmental Impact Assessment (EIA) is applied to infrastructure and other large projects. The European Union EIA Directive (2011/92/EU as amended by 2014/52/EU) requires EIAs to consider the effects that a project might have on human health. The International Association for Impact Assessment and the European Public Health Association prepared a reference paper on public health…
Background Pancreatic cancer (PC) is a complex disease in which both non-genetic and genetic factors interplay. To date, 40 GWAS hits have been associated with PC risk in individuals of European descent, explaining 4.1% of the phenotypic variance. Methods We complemented a new conventional PC GWAS (1D) with genome spatial autocorrelation analysis (2D) permitting to…
The predictive value of work ability for several health and occupational outcomes is well known. Maintaining the ability to work of all employees has become an important topic in research although some evidence suggests that some groups of workers need greater attention than others. Healthcare workers (x¯ = 54.46 ± 5.64 years) attending routine occupational…
Objetivos. Existe gran variabilidad internacional en la incidencia y los resultados en la atención a la parada cardiaca extrahospitalaria (PCRE). El objetivo es conocer si existe variabilidad en la incidencia, características y resultados en supervivencia en la atención a la PCRE por los servicios extrahospitalarios de emergencias (SEM) de España. Método. Análisis descriptivo, retrospectivo de…
Humans are exposed to a myriad of chemical substances in both occupational and environmental settings. Persistent organic pollutants (POPs) have drawn attention for their adverse effects including cancer and endocrine disruption. Herein, the objectives were 1) to describe serum and adipose tissue retinol levels, along with serum retinol binding protein 4 (RBP4) concentrations, and 2)…
“Age-Friendly Cities and Communities” is an initiative launched by the WHO in 2007 that has spread to more than 1000 cities and communities around the world. This initiative is based on an integrated physical and social environment for older people, and a model of participatory, collaborative governance. An enabling social environment setting is just as…
Objetivo Analizar la ratio paciente-enfermera y su asociación con los resultados en salud en hospitales públicos del Servicio Andaluz de Salud (SAS). Método Estudio ecológico transversal realizado en unidades de adultos de 26 hospitales públicos andaluces. Se recogieron datos de estructura (camas, tipo de unidad, control de enfermería), de gestión (estancia media, índice de utilización…
Background Nutrition and lifestyle have been long established as risk factors for colorectal cancer (CRC). Modifiable lifestyle behaviours bear potential to minimize long-term CRC risk; however, translation of lifestyle information into individualized CRC risk assessment has not been implemented. Lifestyle-based risk models may aid the identification of high-risk individuals, guide referral to screening and motivate…
This research aims to explore clusters of a mixture of 15 Persistent Toxic Substances (PTSs) in the adipose tissue of 227 individuals of an adult cohort from Granada Province (Southern Spain). Information about residence and occupation during participants lifetime was gathered by means of validated questionnaires. Clusters of pollutants in the study population were identified…
Background This study provides updated information on Kaposi sarcoma (KS) in Europe during 1995–2007 from the RARECARENet project. Methods Data comes from 59 population-based cancer registries in 22 countries. KS was defined as ICD-O-3 morphology code 9140 combined with any topography code. Crude and age-adjusted incidence rates and relative survival for years of diagnosis 2000–2007…
Background: Early detection of renal cell carcinoma (RCC) has the potential to improve disease outcomes. No screening program for sporadic RCC is in place. Given relatively low incidence, screening would need to focus on people at high risk of clinically meaningful disease so as to limit overdiagnosis and screen-detected false positives. Methods: Among 192,172 participants…
Objectives Through incremental innovation by repositioning, reformulating and combining of off-patent pharmaceuticals, value added medicines (VAMs) offer potential benefits at affordable R&D costs. Current evaluation frameworks are primarily designed for de novo pharmaceuticals, consequently the mismatch between evidence requirements by public decision-makers and the evidence generated by manufacturers prevents exploiting the full societal benefits of…
Objetivo Existe una alta prevalencia de malestar premenstrual en las mujeres españolas que conlleva efectos negativos como el detrimento de su calidad de vida. Adoptando el enfoque biopsicosocial, este estudio pretende conocer las vivencias y las experiencias de las mujeres, indagar en sus creencias y actitudes sobre el síndrome premenstrual y la eliminación de la…
OBJECTIVE Islet autoimmunity is associated with diabetes incidence. We investigated whether there was an interaction between dietary fish intake or plasma phospholipid n-3 polyunsaturated fatty acid (PUFA) concentration with the 65-kDa isoform of GAD (GAD65) antibody positivity on the risk of developing adult-onset diabetes. RESEARCH DESIGN AND METHODS We used prospective data on 11,247 incident…
Background The concept of workability provides a conceptual framework and proposes measures for the evaluation of relevant actions focused on a healthy workforce. In Spain, one of the countries with the highest life expectancy, there are practically no scientific studies on workability and its associated factors. Aims The objective of this study is to examine…
La pandemia de COVID-19ha afectado de manera particularmente intensa a España, pese a su nivel de desarrollo y la elogiada solidez de su Sistema Nacional de Salud. Para comprender qué ha pasado e identificar cómo mejorar la respuesta creemos imprescindible una evaluación independiente multidisciplinaria de la esfera sanitaria, política y socioeconómica. En este trabajo proponemos…
Colorectal cancer risk can be lowered by adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines. We derived metabolic signatures of adherence to these guidelines and tested their associations with colorectal cancer risk in the European Prospective Investigation into Cancer cohort. Methods Scores reflecting adherence to the WCRF/AICR recommendations (scale, 1–5)…
Objetivo Elaborar una herramienta de apoyo que ayude a tomar decisiones en el marco de la pandemia de COVID-19. Método Se parte de una búsqueda de diferentes recomendaciones éticas surgidas en España sobre priorización de recursos sanitarios escasos en la pandemia de COVID-19, así como de una revisión narrativa de modelos teóricos sobre distribución en…
La transmisión del SARS-CoV-2 es un problema de Salud Pública de máxima importancia que está influido por diversos factores. Recientemente se ha planteado la hipótesis de que esta transmisión puede reducirse durante el verano debido a la temperatura cálida. Por otro lado, se está estudiando la posible relación entre el elevado número de contagios de…
Objetivo Conocer las repercusiones del confinamiento por la pandemia de COVID-19 en los autocuidados de personas con enfermedades crónicas y en su salud percibida, e identificar factores para el manejo y la gestión de su enfermedad en situaciones de emergencia. Método Estudio cualitativo realizado en marzo-abril de 2020, durante el confinamiento por la pandemia de…
Objective Health quarantines produce serious deterioration in psychological health, which becomes more affected the longer the quarantine lasts. According to the Conservation of Resources theory from Hobfoll (1989, American Psychologist, 44, 513), those people who have a good supply of resources will be able to cope better with the adversities and will show less distress. The…
Editor 2.0 Journal of Healthcare Quality Research El mes de agosto de 2020, la revista The Lancet 1 publicaba una carta de 20 investigadores españoles pidiendo una evaluación independiente, exhaustiva, integral y multidisciplinar de la gestión de la pandemia en España a nivel del gobierno central y de los gobiernos de las CCAA. Posteriormente, en…
The ongoing pandemic of COVID-19 has already had serious worldwide health, socio-economic, political, and educational consequences. In the present study, we investigated what factors can motivate young adults to comply with the recommended preventive measures against coronavirus infection. Even though young people are less likely to suffer severe medical consequences from the virus, they can…
In relation to COVID-19, little research has focused on the study of variables that affect well-being during this pandemic. The purpose of this research is twofold: (1) to find out if people experiencing a quarantine are able to appreciate any positive aspects of it, and to analyze how these responses are categorized and (2) to…
Background Epidemiological evidence indicates that diets rich in plant foods are associated with a lower risk of ischaemic heart disease (IHD), but there is sparse information on fruit and vegetable subtypes and sources of dietary fibre. This study examined the associations of major plant foods, their subtypes and dietary fibre with risk of IHD in…
Background The prevalence of arterial hypertension (AHT), a well-known risk factor for cardiovascular disease, has considerably increased over last decades. Non-persistent environmental pollutants (npEPs) are a group of ubiquitous chemicals, widely used in consumer products such as food packaging and cosmetics, which have been identified as endocrine disrupting chemicals and obesogens. The aim of this…
Objetivo: Analizar la influencia de factores socioeconómicos, demográficos, epidemiológicos y estructura del sistema de salud en la evolución del COVID-19 en Brasil. Métodos: Estudio ecológico con variables extraídas de bancos de datos, teniendo la incidencia y mortalidad por COVID-19 hasta 23 de agosto de 2020, en estados brasileños, como variables respuesta. Las relaciones han estimadas…
OBJECTIVE Higher plasma vitamin C levels are associated with lower type 2 diabetes risk, but whether this association is causal is uncertain. To investigate this, we studied the association of genetically predicted plasma vitamin C with type 2 diabetes. RESEARCH DESIGN AND METHODS We conducted genome-wide association studies of plasma vitamin C among 52,018 individuals of European…
Type 2 diabetes (T2D) is a global public health challenge. Whilst the advent of genome-wide association studies has identified >400 genetic variants associated with T2D, our understanding of its biological mechanisms and translational insights is still limited. The EPIC-InterAct project, centred in 8 countries in the European Prospective Investigations into Cancer and Nutrition study, is…
La llegada de una vacuna contra el SARS-CoV-2 que pueda frenar la expansión de la infección se ha postulado como la respuesta definitiva para frenar la pandemia de COVID-19. Lejos de ser una solución libre de conflictos éticos, la introducción de una nueva vacuna en la práctica de la salud pública, y que se haga…
Las películas son una experiencia cultural para entender la realidad, pero la realidad es compleja y multidimensional, incomprensible sin la dimensión moral de los hechos que tenemos ante nuestros ojos. La ética narrativa nos permite imaginar ese fondo moral de todos los procesos que acompañan la salud y la enfermedad, en lo individual y en…
Objective: Identify risk factors for microcephaly and evaluate historical trends of microcephaly and arboviruses to recognize patterns and anomalies that indicate the beginning of the microcephaly epidemic associated with Zika infection. Methods: The head circumferences of 62,298 newborns was analyzed to identify cases of microcephaly between 2014 and 2017. We compared the groups of newborns…
Dos cartas publicadas en The Lancet y The Lancet Public Health en los últimos meses defienden la necesidad de evaluar de forma independiente la respuesta española ante la covid-19. Estamos de acuerdo, pero nos gustaría complementarlas con tres puntos que nos acercan a la ciencia abierta. Nos referimos a la confusión terminológica, la calidad de…
To better understand the role of individual and lifestyle factors in human disease, an exposome‐wide association study was performed to investigate within a single study anthropometry measures and lifestyle factors previously associated with B‐cell lymphoma (BCL). Within the European Prospective Investigation into Cancer and nutrition study, 2,402 incident BCL cases were diagnosed from 475,426 participants…
Introducción La emergencia sanitaria global causada por la actual pandemia de COVID-19 está suponiendo un enorme desafío a todos los niveles. El uso de la mascarilla puede reducir la propagación de la infección al minimizar la excreción de las gotitas de Flügge. Así, el objetivo de este trabajo es realizar una recopilación de la evidencia…
Aims: The influence of the COVID-19 pandemic on attendance to out-of-hospital cardiac arrest (OHCA) has only been described in city or regional settings. The impact of COVID-19 across an entire country with a high infection rate is yet to be explored. Methods: The study uses data from 8629 cases recorded in two time-series (2017/2018 and…
Background New approaches on paediatric cancer treatment aim to maintain long-term health. As a result of radiotherapy, chemotherapy or surgery, paediatric cancer survivors tend to suffer from any chronic health condition. Endocrine dysfunction represents one of the most common issues and affects bone health. Exercise is key for bone mass accrual during growth, specifically plyometric…
Obesity is a risk factor for several major cancers. Associations of weight change in middle adulthood with cancer risk, however, are less clear. We examined the association of change in weight and body mass index (BMI) category during middle adulthood with 42 cancers, using multivariable Cox proportional hazards models in the European Prospective Investigation into…
Background Polyphenols are natural compounds with anticarcinogenic properties in cellular and animal models, but epidemiological evidence determining the associations of these compounds with thyroid cancer (TC) is lacking. Objectives The aim of this study was to evaluate the relations between blood concentrations of 36 polyphenols and TC risk in EPIC (the European Prospective Investigation into…
Background Adiposity increases endometrial cancer (EC) risk, possibly through inflammation, hyperinsulinemia, and increasing estrogens. We aimed to quantify the mediating effects of adiponectin (anti-inflammatory adipocytokine); interleukin-6, interleukin-1-receptor antagonist, TNF-receptor-1 and -2, and C-reactive protein (inflammatory status biomarkers); C-peptide (hyperinsulinemia biomarker); free estradiol and estrone (estrogen biomarkers) in the adiposity-EC link in postmenopausal women. Methods We…
Background Evidence from the scientific literature shows a significant variation in greenhouse gas (GHG) emissions from the diet, according to the type of food consumed. We aim to analyze the relationship between the daily dietary GHG emissions according to red meat, fruit and vegetables consumption and their relationship with risk of total mortality, and incident…
Families of children with autism spectrum disorder (ASD) often experience much more negative perceptions of their family quality of life (FQoL). To investigate key factors that may shape these experiences, we conducted a case–control study of sixty-one Spanish families (29 with a child with ASD) using a broad psychosocial assessment (e.g., ASD severity, social support,…
Introducción: En España el 16% de la población consume psicofármacos, ansiolíticos, hipnóti-cos y antidepresivos son los más frecuentes. La prevalencia de consumo es el doble en mujeres que en hombres para todos los rangos de edad. Diversos autores y autoras indican que esta diferencia puede deberse a roles y estereotipos de género.Objetivo: Determinar la prevalencia…
Colorectal cancer (CRC) is the third most common cancer worldwide. Population-based, high-resolution studies are essential for the continuous evaluation and updating of diagnosis and treatment standards. This study aimed to assess adherence to clinical practice guidelines and investigate its relationship with survival. We conducted a retrospective high-resolution population-based study of 1050 incident CRC cases from…
COVID-19 constitutes the largest pandemic in the last 100 years. In view of the rapid spread of the virus, it is necessary to study the sociodemographic characteristics, hygiene habits, activity and mobility, and comorbidities of SARS-CoV-2 infection to be able to implement prevention strategies. For this purpose, a survey including the variables of interest was…
Although we received widespread support from more than 50 scientific societies and associations representing public health, medical, and nursing professional communities; there is now a need to define such an evaluation in terms of its timing, scope, and leadership. Here, we suggest three major requisites and four guiding principles, adapted from McKee and colleagues, which…
In acute coronary syndromes (ACSs), longer decision delay – the time patients wait before seeking medical attention after symptoms have started – increases the risk of complications and death. However, many patients wait much longer than recommended and research is needed investigating how patient decision delay can be reduced. In a cross-sectional study of 120…
Sr. Director: A raíz del debate generado en el grupo de trabajo de bibliotecarios/as de ciencias de la salud #Ayudabiblioteca (https://view.genial.ly/5e92f5a5fba9d40d9e580bcb), creado para hacer frente a las demandas de información por la pandemia de COVID-19, queremos exponer la posición de nuestro colectivo respecto a la coautoría en artículos científicos de revisión. Los trabajos de revisión…
Background The nutritional determinants of stroke and, more specifically, the association of frying with the risk of incident stroke have rarely been studied. Objectives Our aim was to evaluate prospectively the association between the consumption of fried food and the risk of incident stroke in the European Prospective Investigation into Cancer and Nutrition study using…
A lo largo de la última década, la perspectiva teórico-activista de despatologización trans ha contribuido a un cambio en la conceptualización de los procesos de tránsito por los géneros. Partiendo de la observación de una interrelación entre psiquiatrización y violencia transfóbica, grupos activistas por la despatologización trans y personas aliadas demandan la retirada de la…
Vivimos tiempos insólitos, cada vez resulta más evidente que el efecto de la actividad de nuestra sociedad dominada por el neoliberalismo tecno-globalizado tiene efectos muy negativos sobre el bienestar social y del planeta, y abundan las iniciativas científicas para intentar caracterizar la situación actual. Desde la geología han propuesto llamar a nuestra era el Antropoceno,…
Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC)…
Background Bilirubin, a byproduct of hemoglobin breakdown and purported anti-oxidant, is thought to be cancer preventive. We conducted complementary serological and Mendelian randomization (MR) analyses to investigate whether alterations in circulating levels of bilirubin are associated with risk of colorectal cancer (CRC). We decided a priori to perform analyses separately in men and women based…
To analyze the association between prostate cancer (PCa) risk and night shift work, chronotype, and sleep duration in the context of a population-based case-control study of incident prostate cancer in Spain, a total of 465 PCa cases and 410 controls were analyzed. Selection criteria were: (i) age 40–80 years, and (ii) residence in the coverage…
OBJECTIVE There is sparse evidence for the association of suitable food substitutions for red and processed meat on the risk of type 2 diabetes. We modeled the association between replacing red and processed meat with other protein sources and the risk of type 2 diabetes and estimated its population impact. RESEARCH DESIGN AND METHODS The European Prospective…
Objective: To evaluate the relationship between the ownership structure of hospitals and the possibility of their being positioned on the frontier of technical efficiency in the economic crisis period 2010–2012, adjusting for hospital variables and regional characteristics in the areas where the Spanish National Health System (SNHS) hospitals are located. Methods: 230 National Health System hospitals were…
Addressing the characterization of social and economic determinants of health (SDH) properly is a key aspect in conducting a Health Impact Assessment (HIA). This article explores the level of knowledge on HIA environmental and public health professionals have as well as their perception regarding key concepts such as the definition of ‘health’ and the relevance…
Objective Socioeconomic inequalities in colorectal cancer (CRC) survival are a major concern of the Spanish public health system. If these inequalities were mainly due to differences in stage at diagnosis, population-based screening programs might reduce them substantially. We aimed to determine to what extent adverse stage distribution contributed to survival inequalities in a Spanish region…
Sustained B-cell activation is an important mechanism contributing to B-cell lymphoma (BCL). We aimed to validate four previously reported B-cell activation markers predictive of BCL risk (sCD23, sCD27, sCD30, and CXCL13) and to examine their possible mediating effects on the association between anthropometric and lifestyle factors and major BCL subtypes. Pre-diagnostic serum levels were measured…
Hepatocellular carcinoma (HCC) development entails changes in liver metabolism. Current knowledge on metabolic perturbations in HCC is derived mostly from case‐control designs, with sparse information from prospective cohorts. Our objective was to apply comprehensive metabolite profiling to detect metabolites whose serum concentrations are associated with HCC development, using biological samples from within the prospective European…
Background Cardiovascular disease, particularly ischemic heart disease (IHD), is the leading cause of mortality worldwide. Bisphenol A (BPA) is considered an endocrine disruptor and obesogen, present in numerous products of daily use. The aim of this study was to assess the potential association of serum BPA concentrations and the risk of incident IHD in a…
Citrus intake has been suggested to increase the risk of skin cancer. Although this relation is highly plausible biologically, epidemiologic evidence is lacking. We aimed to examine the potential association between citrus intake and skin cancer risk. EPIC is an ongoing multi-center prospective cohort initiated in 1992 and involving ~ 520,000 participants who have been followed-up…
Objetivo Comparar la composición y la funcionalidad de apoyo social de redes personales de personas cuidadoras de Granada y Gipuzkoa en función del sexo y la provincia. Método Estudio transversal con metodología de análisis de redes personales. Se seleccionó una muestra de 66 personas cuidadoras segmentada por sexo en cada provincia. Se recogieron variables de…
Background: Colorectal cancer (CRC) is the most frequently diagnosed cancer in Spain. Socioeconomic inequalities in cancer survival are not documented in Spain. We aim to study the association of socioeconomic inequalities with overall mortality and survival among CRC patients in southern Spain. Methods: We conducted a multilevel population-based cohort study, including CRC cases for the period 2011–…
Introducción El objetivo del estudio es analizar la desigualdad de género en la producción científica de las revistas médicas españolas. Material y método Estudio transversal de las principales revistas médicas españolas clasificadas por SCImago Journal & Country Ranking (n = 24) y sus publicaciones (n = 3.375) durante el año 2017. Se calculó la ratio mujer/hombre de autoría según revista y…
Background: This study aimed at examining the impact of providing healthcare during health emergencies caused by viral epidemic outbreaks on healthcare workers'(HCWs) mental health; to identify factors associated with worse impact, and; to assess the available evidence base regarding interventions to reduce such impact. Method: Rapid systematic review. We searched MEDLINE, Embase, and PsycINFO (inception…
The coronavirus disease 2019 (COVID-19) pandemic has caused an unprecedented global health crisis, with several countries imposing lockdowns to control the coronavirus spread. Important research efforts are focused on evaluating the association of environmental factors with the survival and spread of the virus and different works have been published, with contradictory results in some cases.…
La bioética pública no debería limitarse a ofrecer un conjunto de reglas y modelos de tomas decisiones en «casos difíciles»1, debe ir más allá. Ofrecer razones públicas que contribuyan al diálogo social y a la toma de decisiones institucionales y normativas2. Desde este paradigma, la bioética no debería constreñirse a consejos morales para la toma…
Spain has been hit hard by COVID-19, with more than 300 000 cases, 28 498 confirmed deaths,1 and around 44 000 excess deaths, as of Aug 4, 2020.2 More than 50 000 health workers have been infected, and nearly 20 000 deaths were in nursing homes.3 With a population of 47 million, these data place Spain among the worst affected…
El confinamiento de la población, incluidas las personas investigadoras, pone de manifiesto la necesidad de adaptar la metodología cualitativa, sus técnicas y herramientas, al contexto actual generado por la COVID-19. Internet y los medios o redes sociales posibilitan la recogida de datos textuales, secuencias, imágenes o narrativas sobre una realidad limitada para el acceso a…
4.1 Introduction Mechanical restraint (MR) is used in many countries, including Spain, where non‐harmonized policies between autonomous communities exist. There is a lack of research about interventions at regional levels to reduce their use. 4.2 Aim To analyse data on key outcomes during the implementation of a multicomponent intervention in Andalusia (Spain) to reduce the…
La incidencia y la mortalidad brindan información sobre la carga de la morbilidad del cáncer y los años potenciales de vida perdidos debido al cáncer. Se ha desarrollado el Índice de Privación (IP) como una medida estandarizada para medir la privación socioeconómica en España a nivel de sección censal. Además, se puede combinar la información…
Environmental risks are responsible for one in five of all deaths worldwide. Persistent, bioaccumulative, and toxic substances are chemicals that can subsist for decades in human tissues and the environment. They include heavy metals, organochlorines, polychlorinated biphenyls, organobromines, organofluorines, and polycyclic aromatic hydrocarbons among others. Although humans are often exposed to multiple pollutants simultaneously, their…
Background: Fatty acids impact obesity, estrogens and inflammation, risk factors for ovarian cancer. Few epidemiological studies have investigated the association of fatty acids with ovarian cancer. Methods: Within the European Prospective Investigation into Cancer and nutrition, 1,486 incident ovarian cancer cases were identified. Cox Proportional Hazard models with adjustment for ovarian cancer risk factors were…
Background High carbohydrate intake raises blood triglycerides, glucose, and insulin; reduces HDLs; and may increase risk of coronary heart disease (CHD). Epidemiological studies indicate that high dietary glycemic index (GI) and glycemic load (GL) are associated with increased CHD risk. Objectives The aim of this study was to determine whether dietary GI, GL, and available…
La infancia y la adolescencia marcan, en gran medida, nuestra vida adulta. Las personas más jóvenes están implicadas en una comunidad a su modo y viven también los efectos de la pandemia de la COVID-19. Reflexionar sobre cómo debemos ejercer nuestro papel las personas que nos dedicamos a la atención sanitaria y a la promoción…
Puntos clave La COVID-19 es una infección transmitida por el virus SARS-CoV-2 que, en mayo de 2020, había infectado a más de 5 millones de personas en el mundo y causado probablemente la muerte a más de 325.000 personas. A 18 de mayo, España presentaba la mayor tasa de casos por millón de habitantes y…
The current treatment approach for patients in palliative care (PC) requires a health model based on shared and individualised care, according to the degree of complexity encountered. The aims of this study were to describe the levels of complexity that may be present, to determine their most prevalent elements and to identify factors that may…
The proliferation of arboviruses and their vectors is influenced by a complex interplay between vector, environment and human behaviors. The aim of this work is to analyze the influence of socio-environmental determinants on knowledge and practices regarding arboviruses transmission, among the residents of three communities on the southern border of Mexico. Between June 2017 and…
A recent systematic search of orthopedic surgery literature suggests that scientific risk reporting often deviates from best practices in specific ways (Petrova, Joeris, Sanchez, Salamanca-Fernandez, & Garcia-Retamero, 2018). These deviations could cause dangerous biases in health professionals’ risk interpretations and risk communication practices. To investigate potential vulnerabilities, we conducted the first comparative study estimating the…
Objetivo Analizar la evolución de la epidemia de COVID-19 después del estado de alarma e identificar factores asociados a las diferencias entre las comunidades autónomas. Método Estudio ecológico que utilizó variables epidemiológicas, demográficas, ambientales y sobre la estructura de los servicios sanitarios como variables explicativas. El periodo de análisis fue desde el 15 de marzo…
Background There is a high prevalence of potentially inappropriate prescriptions in primary care. This is associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments. The aim of the present study is to summarise available evidence on the effectiveness of deprescription interventions in primary care,…
En la actual situación de pandemia, la literatura urge a tener en cuenta el enfoque de género para no profundizar las desigualdades existentes, como ya ocurrió en anteriores epidemias. Esta nota de campo pretende describir una experiencia de aplicación del análisis de género al impacto de la pandemia sobre la salud de la población, realizado…
Varios artículos recientes sugieren que la obesidad es un factor de riesgo para una enfermedad más grave por coronavirus. En este artículo se resume la evidencia científica disponible sobre el papel de la obesidad en COVID-19, con especial atención en las personas más jóvenes y los mecanismos biológicos propuestos para explicar tanto el mayor riesgo…
Xian Lu se mudó a Wuhan para cocinar 400 comidas diarias para personal médico durante el pico de la crisis por COVID-19 en la ciudad. Él es uno de los jóvenes reconocidos por la Organización de las Naciones Unidas debido a su esfuerzo en la lucha solidaria contra la pandemia1. En Granada, una médica de…
La pandemia por coronavirus está provocando una crisis de salud pública mundial sobre la que aún desconocemos gran parte de sus manifestaciones clínicas, comportamiento epidemiológico y abordaje terapéutico. También sus consecuencias de tipo social y económico son impredecibles a medio y largo plazo. España está siendo uno de los países más afectados, tanto en incidencia…
Durante la crisis de salud internacional provocada por la pandemia de COVID-19, además de conocer los datos sobre contagios, muertes y ocupación de camas hospitalarias también es necesario hacer predicciones que ayuden a la gestión de la crisis por parte de las autoridades sanitarias. El presente trabajo tiene como objetivo describir la metodología utilizada para…
Background: Urothelial carcinoma (UC) is the predominant (95%) bladder cancer subtype in industrialised nations. Animal and epidemiological human studies suggest that hormonal factors may influence UC risk. Methods: We used an analytic cohort of 333 919 women from the European Prospective Investigation into Cancer and Nutrition Cohort (EPIC). Associations between hormonal factors and incident UC…
Background In acute coronary syndrome the time elapsed between the start of symptoms and the moment the patient receives treatment is an important determinant of survival and subsequent recovery. However, many patients do not receive treatment as quickly as recommended, mostly due to substantial prehospital delays such as waiting to seek medical attention after symptoms…
Objective Limited information is available on the incidence of rare thyroid cancer (TC) subtypes: anaplastic (ATC) and medullary (MTC). The aim of this study was to describe incidence variations and trends across European countries of all TC subtypes. Materials and methods We used the RARECAREnet database including 80721 TC incident cases in the period 2000–2007…
Objective To explore the views of the Internet in childhood, identifying both health assets and risks. Method A qualitative study was performed using 14 focus groups, eight of which comprised boys and girls, four of which comprised parents and two of which were mixed (children and parents) in primary schools in urban and rural settings…
The treatment of patients with bifascicular block (BFB) and syncope in the absence of structural heart disease (SHD) is not well defined. The objective of our study is to compare pacemaker empirical implantation with the use of electrophysiological studies (EPS). This is a prospective cohort study that included 77 patients with unexplained cardiogenic syncope and BFB without structural…
Los pacientes con cáncer: un grupo de riesgo en la pandemia por COVID-19 La mayoría de las personas diagnosticadas de cáncer son personas de edad avanzada (65 o más años) y con una o varias comorbilidades, lo que aumenta el riesgo de sufrir complicaciones debido a la COVID-193. Además, el cáncer y los tratamientos relacionados…
Las crisis, las emergencias y las épocas de disturbios se han relacionado con un aumento de la violencia interpersonal, incluida la violencia hacia las mujeres. A raíz de la declaración de estado de alarma y confinamiento se han puesto en marcha nuevas medidas encaminadas a paliar el posible impacto de la violencia de género (Plan…
Background. Despite the widespread use of organophosphate (OP) pesticides, information on predictors of children’s exposure to such pesticides is scarce. Objective. To assess exposure to OP pesticides in children 3-11 year-old living in agricultural communities and urban areas from Andalusia (Southern Spain), and to identify the main determinants of exposure. Methods. A longitudinal study was…
Background: While Helicobacter pylori (H. pylori) is the major cause of gastric cancer, it has also been suggested to be involved in colorectal cancer (CRC) development. However, prospective studies addressing H. pylori and CRC are sparse and inconclusive. We assessed the association of antibody responses to H. pylori proteins with CRC in the European Prospective…
Objective: to evaluate the effectiveness of strict social distancing measures applied in China in reducing the incidence and mortality from COVID-19 in two Chinese provinces. Methods: We assessed incidence and mortality rates in Hubei and Guangdong before and after the lockdown period in cities in Hubei. An interrupted time series study was conducted to evaluate the effectiveness of…
La historia de la salud pública en España ha sido escrita principalmente en dos revistas que actualmente siguen siendo un referente en su desarrollo académico y profesional. Con trayectorias dispares, la Revista Española de Salud Pública (1926) y Gaceta Sanitaria (1888) comienzan ahora una política de cooperación que pretende situar a la salud pública en la agenda…
Las políticas de envejecimiento activo presentan el concepto de «ciudadanía activa» como un desafío clave en el ámbito del envejecimiento para los próximos años. La ciudadanía activa ha sido definida de diferentes maneras, en la mayoría de los casos de forma complementaria, describiendo un eclecticismo de actividades participativas que incluye la política, el mercado y…
Background: Little is known about the interlinkages between dietary and plasma non-enzymatic antioxidant capacity (D-NEAC and P-NEAC, respectively) and the body’s antioxidant and inflammation response. Our aim was to explore these associations in 210 participants from two Spanish European Prospective Investigation into Cancer and Nutrition (EPIC) centers. (2) Methods: D-NEAC was estimated using published NEAC…
Objetivo: Analizar un conjunto de indicadores para comprender la variabilidad de la evolución y el impacto de la epidemia de COVID-19. Método: Estudio ecológico de países con más de 200 casos notificados. Se han analizado variables demográficas, de gasto sanitario y de características de los servicios sanitarios como variables explicativas, y las tasas de incidencia,…
A substantial proportion of epithelial ovarian cancer (EOC) arises in the fallopian tube and other epithelia of the upper genital tract; these epithelia may incur damage and neoplastic transformation following sexually transmitted infections (STI) and pelvic inflammatory disease. We investigated the hypothesis that past STI infection, particularly Chlamydia trachomatis, is associated with higher EOC risk in…
Background Environmental factors are believed to account for a substantial burden of type 2 diabetes mellitus (T2DM). Non-persistent environmental pollutants (npEPs) are a group of widely-used chemicals identified as endocrine/metabolic disrupting chemicals and obesogens. The aim of this study was to analyse the potential associations of serum levels of three groups of npEPs with the…
Prisons are epicentres for infectious diseases because of the higher background prevalence of infection, the higher levels of risk factors for infection, the unavoidable close contact in often overcrowded, poorly ventilated, and unsanitary facilities, and the poor access to health-care services relative to that in community settings. 1 Infections can be transmitted between prisoners, staff…
Limited evidence exists on the role of modifiable lifestyle factors on the risk of lymphoma. In this work, the associations between adherence to healthy lifestyles and risks of Hodgkin lymphoma (HL) and non‐Hodgkin lymphoma (NHL) were evaluated in a large‐scale European prospective cohort. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), 2,999 incident…
Introduction For stage III colon cancer (CC), surgery followed by chemotherapy is the main curative approach, although optimum times between diagnosis and surgery, and surgery and chemotherapy, have not been established. Materials and methods We analysed a population-based sample of 1912 stage III CC cases diagnosed in eight European countries in 2009–2013 aiming to estimate:…
Background Numerous studies have analysed the effect of comorbidity on cancer outcomes, but evidence on the association between multimorbidity and short-term mortality among colorectal cancer patients is limited. We aimed to assess this association and the most frequent patterns of multimorbidity associated with a higher short-term mortality risk among colorectal cancer patients in Spain. Methods…
Background Adipose tissue has been acknowledged as a potential target for obesogenic pollutants, including toxic metal(loid)s. However, the presence of these chemicals in the adipose tissue has been poorly characterized. Objective To examine the distributions of adipose tissue concentrations of five toxic metal(loid)s (i.e., arsenic [As], nickel [Ni], lead [Pb], tin [Sn], and titanium [Ti])…
Leukocyte telomere length (LTL) is a heritable biomarker of genomic aging. In this study, we perform a genome-wide meta-analysis of LTL by pooling densely genotyped and imputed association results across large-scale European-descent studies including up to 78,592 individuals. We identify 49 genomic regions at a false dicovery rate (FDR) < 0.05 threshold and prioritize genes…
Introducción El objetivo del estudio es analizar la desigualdad de género en la producción científica de las revistas médicas españolas. Material y método Estudio transversal de las principales revistas médicas españolas clasificadas por SCImago Journal & Country Ranking (n=24) y sus publicaciones (n=3.375) durante el año 2017. Se calculó la ratio mujer/hombre de autoría según…
Aim To investigate the associations between major foods and dietary fibre with subtypes of stroke in a large prospective cohort. Methods and results We analysed data on 418 329 men and women from nine European countries, with an average of 12.7 years of follow-up. Diet was assessed using validated country-specific questionnaires which asked about habitual intake over…
Objectives Both pre‐hospital decision delay – the time patients wait before seeking medical attention after symptoms have started – and high psychological distress after the cardiac episode predict poor prognosis of patients with acute coronary syndromes (ACS). We aimed to identify psychosocial markers of these prognostic factors. Design A cross‐sectional study of 102 consecutive, clinically…
Background: The aim of this study was to analyze the trend in socioeconomic inequalities in mortality in small areas due to several specific causes before (2001–2004, 2005–2008) and during (2009–2012) the economic crisis in seven Spanish cities. Methods: This ecological study of trends, with census tracts as the areas of analysis, was based on three…
Background and Objective Acute bacterial skin and skin structure infections (ABSSSIs) have been defined by the US Food and Drug Administration (FDA) in 2013 to include a subset of complicated skin and skin structure infections commonly treated with parenteral antibiotic therapy. Inpatient treatment of ABSSSIs involves a significant economic burden on the healthcare system. This…
Objectives A centralised approach to health technology assessment (HTA) may facilitate optimal use of HTA resources. A regional approach may increase the chances of local implementation of recommendations. This study aimed to compare assessment procedures in England (centralised HTA approach) with Spain (regional HTA approach) discussing key challenges and opportunities from both approaches. Methods We…
Chronic lymphocytic leukemia (CLL) is an incurable disease accounting for almost one‐third of leukemias in the Western world. Aberrant expression of microRNAs (miRNAs) is a well‐established characteristic of CLL, and the robust nature of miRNAs makes them eminently suitable liquid biopsy biomarkers. Using a nested case‐control study within the European Prospective Investigation into Cancer and…
Endometrial cancer (EC) incidence rates vary ~10‐fold worldwide, in part due to variation in EC risk factor profiles. Using an EC risk model previously developed in the European EPIC cohort, we evaluated the prevention potential of modified EC risk factor patterns and whether differences in EC incidence between a European population and low‐risk countries can…
Physical activity has been associated with lower risks of breast and colorectal cancer in epidemiological studies; however, it is unknown if these associations are causal or confounded. In two-sample Mendelian randomisation analyses, using summary genetic data from the UK Biobank and GWA consortia, we found that a one standard deviation increment in average acceleration was…
Patients diagnosed with coronary heart disease should follow lifestyle recommendations that can reduce their cardiovascular risk (e.g., avoid smoking). However, some patients fail to follow these recommendations and engage in unhealthy behavior. With the aim to identify psychosocial factors that characterize patients at high risk of repeated cardiovascular events, we investigated the relationship between social…
According to the most traditional economic evaluation manuals, all “relevant” costs should be included in the economic analysis, taking into account factors such as the patient population, setting, location, year, perspective and time horizon. However, cost information may be designed for other purposes. Health care organisations may lack sophisticated accounting systems and consequently, health economists…
Pro‐inflammatory diets are associated with risk of developing colorectal cancer (CRC), however inconsistencies exist in subsite‐ and sex‐specific associations. The relationship between CRC and combined lifestyle‐related factors that contribute towards a low‐grade inflammatory profile has not yet been explored. We examined the association between the dietary inflammatory potential and an inflammatory profile and CRC risk…
Background Several dietary factors have been reported to be associated with risk of breast cancer, but to date, unequivocal evidence only exists for alcohol consumption. We sought to systematically assess the association between intake of 92 foods and nutrients and breast cancer risk using a nutrient-wide association study. Methods Using data from 272,098 women participating…
BACKGROUND: Mitochondrial DNA (mtDNA) copy number in peripheral blood has been found to be associated with risk of developing several cancers. However, data on pancreatic ductal adenocarcinoma (PDAC) are very limited. METHODS: To further our knowledge on this topic we measured relative mtDNA copy number by a quantitative real-time PCR assay in peripheral leukocyte samples…
Background Although lifestyle factors have been studied in relation to individual non-communicable diseases (NCDs), their association with development of a subsequent NCD, defined as multimorbidity, has been scarcely investigated. The aim of this study was to investigate associations between five lifestyle factors and incident multimorbidity of cancer and cardiometabolic diseases. Methods In this prospective cohort…
Background and aim Coping can be defined as the cognitive efforts and behavioral practices that people develop in situations which they consider to be stressful. In people with Chronic Non-Cancer Pain (CNCP), coping is influenced by the biological, psychological, and socio-cultural resources available to them. The aim of this systematic review is to evaluate the…
Background Physical, psychological and sexual Intimate Partner Violence (IPV) have been described in the literature as different types of IPV experienced by women during pregnancy all over the world. Objectives To systematically review and summarize the empirical evidence on the links between IPV during pregnancy and the perinatal health of mothers and fetuses/neonates. Search Strategy…
The aim of this study conducted in Spain was to analyze and compare burden, severe burden, and satisfaction among informal caregivers in relation to health-related quality of life (HRQoL), type and duration of caregiving, perceived social support, and use of social and health care services. We performed multivariate analyses to identify variables associated with caregiver…
Bisphenol A (BPA) is considered an endocrine disruptor and it is present in numerous products of daily use. The aim of this study was to analyze serum BPA concentrations in a subcohort of the Spanish European Prospective Investigation into Cancer and Nutrition (EPIC), as well as to identify potential predictors of the exposure. The population…
Background Even though in situ breast cancer (BCIS) accounts for a large proportion of the breast cancers diagnosed, few studies have investigated potential risk factors for BCIS. Their results suggest that some established risk factors for invasive breast cancer have a similar impact on BCIS risk, but large population-based studies on lifestyle factors and BCIS…
Introducción Bexsero® (4CMenB), vacuna contra el meningococo B, fue autorizada en Europa en 2013. En España, a pesar de que el meningococo B es la principal causa de enfermedad meningocócica invasiva (EMI), Bexsero® está recomendada y financiada para pacientes con alto riesgo de EMI pero no de forma sistemática en el calendario vacunal del SNS.…
Background Scientific literature has provided clear evidence of the profound impact of sexual violence on women’s health, such as somatic disorders and mental adverse outcomes. However, consequences related to obstetric complications are not yet completely clarified. This study aimed to assess the association of lifetime exposure to intimate partner sexual violence with eclampsia. Methods…
Context. Patients with adrenocortical tumors have been frequently observed to have nonadrenal neoplasia. Objective. To investigate whether patients with benign adrenocortical tumors have a higher likelihood of having nonadrenal neoplasia detected. Design and Participants. Case-control study of patients with benign adrenocortical tumors (cases; n = 400) and normal adrenal glands (controls; n = 400), who underwent repeated abdominal cross-sectional…
Background Cancer Antigen 125 (CA125) is currently the best available ovarian cancer screening biomarker. However, CA125 has been limited by low sensitivity and specificity in part due to normal variation between individuals. Personal characteristics that influence CA125 could be used to improve its performance as screening biomarker. Methods We developed and validated linear and dichotomous…
Aims/hypothesis Type 1 and type 2 diabetes differ with respect to pathophysiological factors such as beta cell function, insulin resistance and phenotypic appearance, but there may be overlap between the two forms of diabetes. However, there are relatively few prospective studies that have characterised the relationship between autoimmunity and incident diabetes. We investigated associations of…
Objetivo: Mepolizumab está indicado como tratamiento adicional del asma eosinofílica refractaria grave. Las diferencias observadas en subgrupos poblacionales según recuento eosinofílico plasmático, existencia de pacientes con altos niveles de inmunoglobulina E candidatos a omalizumab y mepolizumab, e impacto económico de mepolizumab obligan a realizar estudios económicos para tomar decisiones clínicas eficientes. El objetivo fue realizar un análisis de coste/eficacia e impacto…
Purpose The evidence from the literature regarding the association of dietary factors and risk of prostate cancer is inconclusive. Methods A nutrient-wide association study was conducted to systematically and comprehensively evaluate the associations between 92 foods or nutrients and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cox proportional…
Purpose Advanced glycation end products (AGEs) can be formed in foods by the reaction of reducing sugars with proteins, and have been shown to induce insulin resistance and obesity in experimental studies. We examined the association between dietary AGEs intake and changes in body weight in adults over an average of 5 years of follow-up. Methods…
The main aim of this study was to determine the association of various clinical, functional and pharmacological factors with the physical (PCS) and mental (MCS) summary components of the health-related quality of life (HRQoL) of community-dwelling older adults. Design: Cross-sectional study. Patients and setting: Sample of 573 persons aged over 65 years, recruited at 12…
Introduction Despite the enormous potential for adverse events in primary healthcare (PHC), the knowledge about how to improve patient safety in this context is still sparse. We describe the methods for the development and evaluation of an intervention targeted at PHC professionals to improve patient safety in Spanish PHC centres. Methods and analysis The intervention…
Background & Aims Early-onset colorectal cancer (CRC, in persons younger than 50 years old) is increasing in incidence; yet, in the absence of a family history of CRC, this population lacks harmonized recommendations for prevention. We aimed to determine whether a polygenic risk score (PRS) developed from 95 CRC-associated common genetic risk variants was associated…
Purpose With better access to early diagnosis and appropriate treatment, cervical cancer (CC) burden decreased in several European countries. In Eastern European (EE) countries, which accessed European Union in 2004, CC survival was worse than in the rest of Europe. The present study investigates CC survival differences across five European regions, considering stage at diagnosis…
Heavy metals and other toxic elements are frequently detected in humans. Rare earth elements (REE) have arisen as a novel group of substances considered as emerging pollutants due to its dependence for high tech industry. We designed a study aimed to conduct the biomonitoring a total of 45 inorganic elements in the population of Andalusia…
Background Cancer is a major public health problem worldwide. The GLOBOCAN estimated 18.1 million new cases of cancer and 9.6 million deaths from cancer in 2018. In some of the more frequent cancers, mortality can be significantly reduced through cancer screening programs. Nevertheless, socially disadvantaged groups have difficulties in benefitting from these screening programs, especially…
Multiple Criteria Decision Analysis (MCDA) has emerged as a likely methodology for Health Technology Assessment (HTA). However limited empirical evidence is available on its use by decision-makers and only as part of single-setting exercises, without cross-county studies available. This pilot study applies the Advance Value Framework (AVF), an MCDA methodology for HTA based on multi-attribute…
The aim was to evaluate the associations of environmental phenol and paraben concentrations with the oxidative microenvironment in adipose tissue. This study was conducted in a subsample (n = 144) of the GraMo cohort (Southern Spain). Concentrations of 9 phenols and 7 parabens, and levels of oxidative stress biomarkers were quantified in adipose tissue. Associations were estimated…
Background: Except for a documented increase in osteoprotegerin (OPG) concentrations with older age, data on determinants of soluble Receptor Activator of Nuclear Factor κB (sRANKL) and OPG concentrations in women are limited. We evaluated reproductive and lifestyle factors as potential sources of variation in circulating sRANKL and OPG concentrations in pre- and postmenopausal women. Methods:…
Background: The aim of this study was to develop a spending predictor model to evaluate the direct costs associated with the management of ABSSSIs from the National health-care provider’s perspective of Italy, Romania, and Spain. Methodology: A decision-analytic model was developed to evaluate the diagnostic and clinical pathways of hospitalized ABSSSI patients based on scientific…
Experimental studies have reported on the anti-inflammatory properties of polyphenols. However, results from epidemiological investigations have been inconsistent, and especially studies using biomarkers for assessment of polyphenol intake have been scant. We aimed to characterize the association between plasma concentrations of 35 polyphenol compounds and low-grade systemic inflammation state as measured by high-sensitivity C-reactive protein…
Pancreatic cancer (PC) is a highly fatal cancer with currently limited opportunities for early detection and effective treatment. Modifiable factors may offer pathways for primary prevention. In this study, the association between the Healthy Lifestyle Index (HLI) and PC risk was examined. Within the European Prospective Investigation into Cancer and Nutrition cohort, 1113 incident PC…
Aim The present systematic review aimed at assessing the degree of compliance with supportive periodontal/peri‐implant therapy as well as identifying patient‐related factors that could potentially play a role on patient compliance. Methods Electronic and manual literature searches were carried out to assess patient compliance during maintenance. Main outcomes were compliance definition, degree of compliance and…
Background. Organized screening programs often rely on written materials to inform the public. In the United Kingdom, women invited for cervical cancer screening receive a leaflet from the National Health Service (NHS) to support screening decisions. However, information about screening may be too complex for people to understand, potentially hindering informed decision making. Objectives. We…
Background Metabolomics is a promising molecular tool to identify novel etiologic pathways leading to cancer. Using a targeted approach, we prospectively investigated the associations between metabolite concentrations in plasma and breast cancer risk. Methods A nested case-control study was established within the European Prospective Investigation into Cancer cohort, which included 1624 first primary incident invasive…
Receiver operating characteristic (ROC) analysis is used for comparing predictive models in both model selection and model evaluation. ROC analysis is often applied in clinical medicine and social science to assess the tradeoff between model sensitivity and specificity. After fitting a binary logistic or probit regression model with a set of independent variables, the predictive…
Objetivo Describir la asociación entre la caminabilidad del barrio de residencia y la mortalidad. Método Estudio ecológico de áreas pequeñas. Se calcularon las razones de mortalidad estandarizadas (RME) y el Walk Score© en cada sección censal. Los valores se compararon con pruebas paramétricas y no paramétricas. Resultados En los hombres, las RME medias para enfermedades…
Background One of the greatest effects of the financial crisis in Spain has been the enormous increase in the number of evictions. Several studies have shown the association of evictions with different aspects of the physical and mental health. Furthermore, evictions have been associated with an increased risk of suicide. Our objective was to evaluate…
Evidence suggests an influence of sex hormones on cutaneous melanoma risk, but epidemiologic findings are conflicting. We examined the associations between use of oral contraceptives (OCs) and menopausal hormone therapy (MHT) and melanoma risk in women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in…
Importance Soft drinks are frequently consumed, but whether this consumption is associated with mortality risk is unknown and has been understudied in European populations to date. Objective To examine the association between total, sugar-sweetened, and artificially sweetened soft drink consumption and subsequent total and cause-specific mortality. Design, Setting, and Participants This population-based cohort study involved…
Longitudinal targeted maximum likelihood estimation (LTMLE) has very rarely been used to estimate dynamic treatment effects in the context of time‐dependent confounding affected by prior treatment when faced with long follow‐up times, multiple time‐varying confounders, and complex associational relationships simultaneously. Reasons for this include the potential computational burden, technical challenges, restricted modeling options for long…
Higher circulating 25-hydroxyvitamin D levels (25(OH)D) have been found to be associated with lower risk for colorectal cancer (CRC) in prospective studies. Whether this association is modified by genetic variation in genes related to vitamin D metabolism and action has not been well studied in humans. We investigated 1307 functional and tagging single-nucleotide polymorphisms (SNPs;…
Background Bile acids have been proposed to promote colon carcinogenesis. However, there are limited prospective data on circulating bile acid levels and colon cancer risk in humans. Methods Associations between pre-diagnostic plasma levels of 17 primary, secondary and tertiary bile acid metabolites (conjugated and unconjugated) and colon cancer risk were evaluated in a nested case-control…
Introduction Beverage consumption is a modifiable risk factor for type 2 diabetes (T2D), but there is insufficient evidence to inform the suitability of substituting 1 type of beverage for another. Objective The aim of this study was to estimate the risk of T2D when consumption of sugar-sweetened beverages (SSBs) was replaced with consumption of fruit…
Objective To summarize the results from observational studies examining the risk of fetal and neonatal death (perinatal death) as a function of the experience of Intimate Partner Violence (IPV) during pregnancy and examine the influence of socioeconomic context indicators on this association. Data sources Bibliographic searches were conducted in PubMed, EMBASE, CINAHL, and LILACS until…
Objective To compare the survival among patients with chronic kidney disease who had optimal starts of renal replacement therapy, dialysis or hemodialysis, with patients who had suboptimal starts. Methods A retrospective cohort consisting of >18 year-old patients who started renal replacement therapy, using peritoneal dialysis or hemodialysis, in any public hospital or associated center of…
Levels of dialkylphosphate (DAP) metabolites were measured in hair and urine of children that lived close to intensively farmed areas of Almeria (Southeast Spain). The levels were used as proxies for exposure of these children to organophosphate pesticides (OPs). Determinants of exposure to DAPs were also examined. Urine and hair samples were collected from 222…
Polyphenols are bioactive compounds with several anticarcinogenic activities; however, human data regarding associations with thyroid cancer (TC) is still negligible. Our aim was to evaluate the association between intakes of total, classes and subclasses of polyphenols and risk of differentiated TC and its main subtypes, papillary and follicular, in a European population.The European Prospective Investigation…
Purpose To comparatively assess the prevalence rates of potentially inappropriate medications (PIMs) obtained by the former and latest versions of American Geriatrics Society Beers Criteria (AGS BC) and screening tool of older person’s potentially inappropriate prescriptions (STOPP), and analyze the factors of influence on PIM. Methods Cross-sectional study including 582 community-dwelling older adults over the…
Background: Our main objective was to evaluate the fundamental biases detected in studies assessing the effects the Great Recession had on health for the case of Spain. As secondary objectives we presented methods to control these biases and to discuss the results of the studies in question if they had controlled for them. Methods: We…
This study aimed to assess the association between exposure to chromium and neuropsychological development among children. A cross-sectional study was conducted with 393 children aged 6–11 years old randomly selected from State-funded schools in two provinces in Southern Spain (Almeria and Huelva), in 2010 and 2012. Chromium levels in urine and hair samples were analyzed…
Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HR) (95% confidence intervals) were estimated…
We investigated what factors may foster or hinder physicians’ cancer screening risk literacy–specifically the ability to understand evidence regarding screening effectiveness and make evidence-based recommendations to patients. In an experiment, physicians in training (interns and residents) read statistical information about outcomes from screening for cancer, and had to decide whether to recommend it to a…
Background & Aims There is an unclear association between intake of fish and long-chain n-3 polyunsaturated fatty acids (n-3 LC-PUFAs) and colorectal cancer (CRC). We examined the association between fish consumption, dietary and circulating levels of n-3 LC-PUFAs, and ratio of n-6:n-3 LC-PUFA with CRC using data from the European Prospective Investigation into Cancer and…
Objetivo Comparar las diferencias en la producción científica mundial sobre paternidad y maternidad (cantidad, momento de inicio y evolución temporal), conocer la distribución geográfica internacional de artículos sobre paternidad, y examinar la relación del índice de desarrollo humano (IDH) y del índice global de brecha de género (IGBG) con el número de artículos sobre paternidad.…
Background: Energy balance is defined as the difference between energy expenditure and energy intake. The current state of knowledge supports the need to better integrate mechanistic approaches through effective studies of energy balance in the cancer population because of an observed significant lack of adherence to healthy lifestyle recommendations. To stimulate changes in breast cancer…
The objective of this article is to analyze the ratio of cost-effectiveness and budgetary impact of lenalidomide treatment in patients with multiple myeloma who have undergone autologous transplant in Spain. The analyses were based on clinical trials CALGB 100104 and IFM 2005-02, from the perspective of the National Health System. The alternatives compared were the…
Background Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence. Objective The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries. Methods Dietary intake data were used, assessed by country-specific questionnaires…
Background: To analyze the potential effect of social inequality on pancreatic cancer risk in Western Europe, by reassessing the association within the European Prospective Investigation into Cancer and Nutrition (EPIC) Study, including a larger number of cases and an extended follow-up. Methods: Data on highest education attained were gathered for 459,170 participants (70% women) from…
Introduction Stillbirth, one of the urgent concerns of preventable perinatal deaths, has wide-reaching consequences for society. We studied secular stillbirth trends by maternal socioeconomic status (SES) in Spain. Methods We developed a population-based observational study, including 4 083 919 births during 2007–15. We estimate stillbirth rates and secular trends by maternal SES. We also evaluated…
Objective The main aims of this paper are to analyse the monetary value of informal care time using different techniques and to identify significant variables associated with the number of caregiving hours. Data and methods A multicentre study in two Spanish regions in adult caregivers was conducted. A total sample of 604 people was available.…
Four epidemiologic studies have assessed the association between nut intake and pancreatic cancer risk with contradictory results. The present study aims to investigate the relation between nut intake (including seeds) and pancreatic ductal adenocarcinoma (PDAC) risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Cox proportional hazards models were used to estimate…
In Spain, the average waiting time for a specialist consultation is 58 days. A determinant factor that contributes to this situation is the poor communication between primary care and specialised care, which is mainly due to the waiting days for a consultation, number of avoided/avoidable face-to-face referrals, and waiting days for the resolution of the…
Background Microseminoprotein-beta (MSP), a protein secreted by the prostate epithelium, may have a protective role in the development of prostate cancer. The only previous prospective study found a 2% reduced prostate cancer risk per unit increase in MSP. This work investigates the association of MSP with prostate cancer risk using observational and Mendelian randomization (MR)…
Se presenta una metodología cualitativa de diseño participativo para la realización del plan de social media (PSM) para organizaciones sanitarias, así como la evaluación de la experiencia en el Hospital Universitario Reina Sofía. La metodología de diseño colaborativo y multidisciplinar se desarrolló en cinco fases: identificación de agentes clave; consenso sobre objetivos, públicos, canales y…
Obesity has been associated with upper gastrointestinal cancers; however, there are limited prospective data on associations by subtype/subsite. Obesity can impact hormonal factors, which have been hypothesized to play a role in these cancers. We investigated anthropometric and reproductive factors in relation to esophageal and gastric cancer by subtype and subsite for 476,160 participants from…
Objetivo Describir la evolución de la morbilidad psíquica en la población adulta española en 2006, 2011 y 2017. Estudiar la salud mental en 2017, determinando la prevalencia de morbilidad psíquica, consumo de psicofármacos, diagnóstico y salud autopercibida. Todo ello tanto en el ámbito nacional como por comunidades autónomas, y diferenciando entre hombres y mujeres. Método…
Selenoprotein genetic variations and suboptimal selenium (Se) levels may contribute to the risk of colorectal cancer (CRC) development. We examined the association between CRC risk and genotype for single nucleotide polymorphisms (SNPs) in selenoprotein and Se metabolic pathway genes. Illumina Goldengate assays were designed and resulted in the genotyping of 1040 variants in 154 genes…
Objective To compare the use of health technology assessment (HTA) as a tool to support pricing and reimbursement (P&R) of new medicines in Spain with England, Sweden, France and Germany. Method For each country, the literature is used to identify the purpose and timing of the P&R decision, the HTA and decision-making procedures used to…
Objetivo Evaluar el acceso al mercado de los medicamentos huérfanos en España que a fecha de 31 de diciembre de 2017 tuvieran vigente su designación, y para aquellos comercializados en España estimar los tiempos entre la asignación de código nacional (CN) por parte de la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) y la…
Background: There is uncertainty about the relevance of animal foods to the etiology of ischemic heart disease (IHD). We examined meat, fish, dairy products and eggs and risk for IHD in the pan-European EPIC cohort. Methods: A prospective study of 409,885 men and women in nine European countries. Diet was assessed using validated questionnaires, calibrated…
Population‐based cancer registry data from three Spanish areas were used to assess the patterns of care and adherence to guidelines for cutaneous malignant melanoma. We included 934 cases diagnosed in 2009–2013. Completeness of the pathology reports, imaging for detecting distant metastasis and the use of sentinel lymph node biopsy (SLNB) were analysed. The proportion of…
Evaluar el impacto de la formación entre iguales de la Escuela de Pacientes sobre la salud autopercibida y los hábitos de vida de las personas con enfermedades crónicas. Diseño Descriptivo, transversal de evaluación cuantitativa pretest/postest. Emplazamiento Andalucía. Participantes Novecientos sesenta y cuatro pacientes con diabetes, fibromialgia e insuficiencia cardíaca participantes en la Escuela de Pacientes…
Alcohol consumption is associated with higher risk of breast cancer (BC); however, the biological mechanisms underlying this association are not fully elucidated, particularly the extent to which this relationship is mediated by sex hormone levels. Circulating concentrations of estradiol, testosterone, their free fractions and sex‐hormone binding globulin (SHBG), were examined in 430 incident BC cases…
En 2009, Grant y Booth identificaron hasta 14 tipos diferentes de revisiones de la literatura, desde la revisión narrativa hasta la más actual umbrella review , y afirmaban que muchos de estos tipos de revisiones no tienen una metodología precisa ni son mutuamente excluyentes. Una de las formas de síntesis de la literatura más actuales…
Background Colorectal cancer (CRC) is the second cause of tumour mortality in Spain and Europe. To date, no studies have been conducted in Spain to evaluate the spatial and temporal distribution of the excess risk of death during hospitalisation for CRC. Methods A cohort was constructed of all episodes of hospitalisation in Spain due to…
Introducción El objetivo de este artículo fue explorar, analizar y sintetizar las experiencias emocionales de profesionales sanitarios de donación y trasplantes. Método Se realizó una revisión sistemática cualitativa en Medline, Science Direct y la Biblioteca Virtual del Sistema Sanitario Público de Andalucía. Se seleccionaron 16 artículos originales, realizando una evaluación cualitativa y síntesis narrativa. Resultados…
Metabolomics may reveal novel insights into the aetiology of prostate cancer, for which few risk factors are established. We investigated the association between patterns in baseline plasma metabolite profile and subsequent prostate cancer risk, using data from 3057 matched case‐control sets from the European Prospective Investigation into Cancer and Nutrition (EPIC). We measured 119 metabolite…
Background: CA125 is the most promising ovarian cancer screening biomarker to date. Multiple studies reported CA125 levels vary by personal characteristics, which could inform personalized CA125 thresholds. However, this has not been well described in premenopausal women. Methods: We evaluated predictors of CA125 levels among 815 premenopausal women from the New England Case Control Study…
Introduction Chronic inflammation plays a critical role in lymphomagenesis and several dietary factors seem to be involved its regulation. The aim of the current study was to assess the association between the inflammatory potential of the diet and the risk of lymphoma and its subtypes in the European Investigation into Cancer and Nutrition (EPIC) study.…
The financial crisis has caused an exponential increase of home foreclosures in Spain. Recent studies have shown the effects that foreclosures have on mental and physical health. This study explores these effects on a sample of adults in the city of Granada (Spain), in terms of socio-demographic, socio-economic and process characteristics. A cross-sectional survey was…
Background Mortality from malignant cutaneous melanoma increased alarmingly during the second half of the 20th century in Spain and other European countries. Objective The aim was to analyze sex and age‐specific trends in melanoma mortality in Spain in the period 1982‐2016. Methods European age‐standardized melanoma mortality rates during the period 1982‐2016 were calculated from mortality…
Background The objective of this review was to investigate trends in clinical trial design, specifically, the primary outcomes used, interpretation of results, and the magnitude of the benefits described in phase III controlled clinical trials in the first‐line treatment of patients with advanced non‐small cell lung cancer (NSCLC). Methods Seventy‐six trials published between 2000 and…
Andalusia is a region in the south of Spain with 8,4 million inhabitants of which 1,3 million are over 65 years old. Andalusia has been recognized as Reference Site by the European Commission within the European Innovation Partnership on Active and Healthy Aging. The Regional Ministry of Health of Andalusia has put in place strategies…
Objetivo Evaluar el impacto del Plan de Promoción de la Autonomía Personal y Prevención de la Dependencia de Andalucía (2016-2020) en 13 organismos públicos participantes tras su primer año, y analizar la usabilidad y la fiabilidad de la escala de evaluación del impacto que se ha empleado. Método El Plan aborda la promoción de la…
Una vez más, presentamos el informe de la actividad realizada por el equipo editorial a lo largo del año anterior y los datos de desempeño de la revista, con el fin de rendir cuentas a nuestros/as lectores/as, a las personas socias de SESPAS y a la sociedad. El documento permite analizar los avances y las…
The associations of individual dietary fatty acids with prostate cancer risk have not been examined comprehensively. We examined the prospective association of individual dietary fatty acids with prostate cancer risk overall, by tumor subtypes, and prostate cancer death. 142,239 men from the European Prospective Investigation into Cancer and Nutrition who were free from cancer at…
Background Earlier age at menopause has been associated with increased risk of coronary heart disease (CHD), but the shape of association and role of established cardiovascular risk factors remain unclear. Therefore, we examined the associations between menopausal characteristics and CHD risk; the shape of the association between age at menopause and CHD risk; and the…
OBJECTIVE To estimate the causal association between intake of dairy products and incident type 2 diabetes. RESEARCH DESIGN AND METHODS The analysis included 21,820 European individuals (9,686 diabetes cases) of the EPIC-InterAct case-cohort study. Participants were genotyped, and rs4988235 (LCT-12910C>T), a SNP for lactase persistence (LP) which enables digestion of dairy sugar, i.e., lactose, was…
Objetivo Evaluar la evidencia sobre el uso de heurísticos de representatividad, disponibilidad, anclaje y ajuste y exceso de confianza en la práctica clínica real, específicamente en el ámbito de la Atención Primaria. Diseño Revisión panorámica (scoping review). Fuentes de datos Bases de datos de OvidMedline, Scopus, PsycoINFO, Cochrane Library y PubMed. Con el fin de…
People with low statistical numeracy have difficulties understanding numerical information. For instance, they often misunderstand the probability of experiencing side effects, which could reduce adherence to medical treatments. We investigated whether presenting information about probability using a method based on the direct experience of events influences the accuracy of probability estimates compared to viewing a…
Published associations between dietary folate and bladder cancer risk are inconsistent. Biomarkers may provide more accurate measures of nutrient status. This nested case‐control analysis within the European Prospective Investigation into Cancer and Nutrition (EPIC) investigated associations between pre‐diagnostic serum folate, homocysteine, vitamins B6 and B12 and the risk of urothelial cell carcinomas of the bladder…
Objective To identify and characterize the interventions that aimed to improve cancer treatment and follow‐up care in socially disadvantaged groups. To summarize the state‐of‐the‐art for clinicians and researchers. Methods We conducted a systematic review following PRISMA guidelines. Eligible studies were randomized controlled trials and quasi‐experimental studies with a control group (usual care or enhanced usual…
Fundamentos: La prestación de cuidados informales determina la existencia de desigualdades en salud, a las cuales se suman las desigualdades de género por el papel mayoritario de las mujeres en dicha prestación. Los objetivos de este estudio fueron caracterizar a la población cuidadora informal de mayores dependientes en Gipuzkoa, conocer los impactos de cuidar sobre…
Objectives and setting Although psychotropic drugs are used to treat mental health disorders, little evidence analyses the effects the 2008 economic downturn had on psychotropic drug consumption in the case of Spain. We analyse these effects, considering both gender and employment situation. Participants We used the microdata from the face-to-face cross-sectional population-based Spanish National Health…
Previous prospective studies assessing the relationship between circulating concentrations of vitamin D and prostate cancer risk have shown inconclusive results, particularly for risk of aggressive disease. In this study, we examine the association between prediagnostic concentrations of 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] and the risk of prostate cancer overall and by tumor characteristics.…
Gaceta Sanitaria viene intensificando el trabajo por la integridad y la eficiencia en la publicación científica desde el año 20171, en cumplimiento con el compromiso adquirido mediante la adhesión a la iniciativa REWARD liderada por The Lancet2,3. Las revistas científicas tenemos una enorme responsabilidad en el proceso de selección, edición y publicación de la ciencia.…
There is growing evidence of the protective role of the Mediterranean diet (MD) on cancer. However, no prospective study has yet investigated its influence on lymphoma. We evaluated the association between adherence to the MD and risk of lymphoma and its subtypes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The analysis…
Gallstones, a common gastrointestinal condition, can lead to several digestive complications and can result in inflammation. Risk factors for gallstones include obesity, diabetes, smoking and physical inactivity, all of which are known risk factors for colorectal cancer (CRC), as is inflammation. However, it is unclear whether gallstones are a risk factor for CRC. We examined…
Background & Aims Evidence on the association between physical activity and risk of hepatobiliary cancers is inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Methods We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBC), and 164 non-gallbladder extrahepatic bile duct cancers (NGBC) among…
Background The use of biomarkers of environmental exposure to explore new risk factors for pancreatic cancer presents clinical, logistic, and methodological challenges that are also relevant in research on other complex diseases. Objectives First, to summarize the main design features of a prospective case-control study –nested within the European Prospective Investigation into Cancer and Nutrition…
Social support is an important predictor of the health of a population. Few studies have analyzed the influence of caregivers’ personal networks from a gender perspective. The aim of this study was to analyze the composition, structure, and function of informal caregiver support networks and to examine gender differences. It also aimed to explore the…
Background The use of biomarkers of environmental exposure to explore new risk factors for pancreatic cancer presents clinical, logistic, and methodological challenges that are also relevant in research on other complex diseases. Objectives First, to summarize the main design features of a prospective case-control study –nested within the European Prospective Investigation into Cancer and Nutrition…
The objective of this systematic literature review is to examine the impact of interventions to improve cardiovascular disease healthcare provided to people living in rural areas. Systematic electronic searches were conducted in Medline, CINAHL, Embase, Scopus, and Web of Knowledge in July 2018. We included clinical trials assessing the effectiveness of interventions to improve cardiovascular…
Ovarian cancer risk factors differ by histotype; however, within subtype there is substantial variability in outcomes. We hypothesized that risk factor profiles may influence tumor aggressiveness, defined by time between diagnosis and death, independent of histology. Among 1.3 million women from 21 prospective cohorts, 4,584 invasive epithelial ovarian cancers were identified and classified as highly…
Objetivo Conocer la valoración de personas migrantes sobre su acceso al sistema sanitario tras la entrada en vigor del Real Decreto-Ley16/2012 y sobre el efecto que han podido producir los recortes económicos en dicho acceso. Método Estudio cualitativo fenomenológico con entrevistas semiestructuradas, realizado en Andalucía, en dos fases (2009-2010 y 2012-2013), con 36 participantes. Se…
Classical epidemiology has focused on the control of confounding, but it is only recently that epidemiologists have started to focus on the bias produced by colliders. A collider for a certain pair of variables (e.g. an outcome Y and an exposure A) is a third variable (C) that is caused by both. In a directed…
Cardiac patients who have social support generally have better prognosis than patients who lack social support. Several theoretical mechanisms have been proposed to explain this protective effect, including the capacity of social support to buffer the negative effects of stress. We tested this buffering effect in a study of patients hospitalized for acute coronary syndrome…
MTHFR is a key enzyme in folate metabolism. Some genetic polymorphisms code for a less efficient enzyme, increasing serum concentrations of homocysteine. This has been associated with inadequate feto-maternal circulation and increased risk of spontaneous abortion. Paroxonase 1 (PON1) is a multifunctional enzyme that can detoxify homocysteine through its homocysteine thiolactonase activity. We evaluate the…
Purpose Coffee and tea constituents have shown several anti-carcinogenic activities in cellular and animal studies, including against thyroid cancer (TC). However, epidemiological evidence is still limited and inconsistent. Therefore, we aimed to investigate this association in a large prospective study. Methods The study was conducted in the EPIC (European Prospective Investigation into Cancer and Nutrition)…
Purpose: Renal cell carcinoma (RCC) has the potential for cure with surgery when diagnosed at an early stage. Kidney injury molecule-1 (KIM-1) has been shown to be elevated in the plasma of RCC patients. We aimed to test whether plasma KIM-1 could represent a means of detecting RCC prior to clinical diagnosis. Experimental Design: KIM-1…
Se presenta una experiencia práctica de implantación de la Cuádruple Hélice basada en el Modelo de Innovación de los Reference Sites de la Comisión Europea, a través del método Design Thinking. Este método establece que, para alcanzar con éxito el diseño de una solución digital, deben cubrirse cinco fases ineludibles: empatizar, definir, idear, prototipar y…
Background Few published breast cancer (BC) risk prediction models consider the heterogeneity of predictor variables between estrogen-receptor positive (ER+) and negative (ER-) tumors. Using data from two large cohorts, we examined whether modeling this heterogeneity could improve prediction. Methods We built two models, for ER+ (ModelER+) and ER- tumors (ModelER-), respectively, in 281,330 women (51%…
Objetivo Evaluar una actividad formativa entre iguales para pacientes con cáncer de mama desde la perspectiva de género; conocer los resultados y profundizar en las experiencias de pacientes y profesionales sanitarios participantes. Método: Diseño multicéntrico mixto (Andalucía, 2017) con un cuestionario de evaluación pretest/postest con 102 pacientes formadas, midiendo hábitos de vida, limitaciones, uso y…
Purpose The numerical format in which risks are communicated can affect risk comprehension and perceptions of medical professionals. We investigated what numerical formats are used to report absolute risks in empirical articles, estimated the frequency of biasing formats and rated the quality of figures used to display the risks. Design Descriptive study of reporting practices.…
La seguridad del paciente es un componente esencial de la calidad asistencial, especialmente cuando la complejidad de la asistencia ha alcanzado niveles extremos. En la actualidad, conseguir esta seguridad se considera una estrategia básica del sistema nacional de salud. Los servicios de Medicina Nuclear muestran unas particularidades que los hacen especiales en materia de seguridad…
El objetivo de este trabajo es revisar los derechos de las personas trans e intersex en la legislación actualmente vigente en el contexto español, tomando como referencia las recomendaciones establecidas por organismos internacionales y regionales de derechos humanos y las demandas expresadas por el activismo internacional por la despatologización trans y el movimiento intersex internacional.…
Objectives To estimate the prevalence of disabling chronic pain (DCP) in Spanish adults, to analyse its characteristics, to determine its multimorbidity and to identify its associated factors. Settings 2011 Andalusian Health Survey, a cross-sectional population survey based on face-to-face home interviews. Participants 6507 people aged 16 years or older and living in Andalusia, Spain. Outcomes…
Background Existing evidence for the prospective association of vitamin D status with type 2 diabetes (T2D) is focused almost exclusively on circulating total 25-hydroxyvitamin D [25(OH)D] without distinction between its subtypes: non-epimeric and epimeric 25(OH)D3 stereoisomers; and 25(OH)D2, the minor component of 25(OH)D. We aimed to investigate the prospective associations of circulating levels of the…
Survival for breast cancer (BC) is lower in eastern than northern/central Europe, and in older than younger women. We analysed how comorbidities at diagnosis affected whether selected standard treatments (STs) were given, across Europe and over time, also assessing consequences for survival/relapse. We analysed 7,581 stage I/IIA cases diagnosed in 9 European countries in 2009−13,…
Spain has a reference price system (RPS) for off-patent medicines since 1997. In addition, from 2012, Andalusia is running a series of tenders for procuring off-patent medicines dispensed by community pharmacies, for those medicines included in the system of homogenous clusters within the national reference price system. Such tenders offer additional savings to the regional…
Objetivos Explorar los conocimientos y las actitudes de los médicos de Atención Primaria de Andalucía sobre la detección de personas con riego elevado de cáncer de mama y colorrectal y el cáncer hereditario. Métodos Estudio descriptivo transversal a partir de una encuesta de opinión on line. Cuestionario de 24 preguntas. Para el análisis estadístico se…
Background Receptor activator of nuclear factor kappa-B (RANK)-signaling is involved in tumor growth and spread in experimental models. Binding of RANK ligand (RANKL) to RANK activates signaling, which is inhibited by osteoprotegerin (OPG). We have previously shown that circulating soluble RANKL (sRANKL) and OPG are associated with breast cancer risk. Here we extend these findings…
Purpose The third most frequently diagnosed cancer in Europe in 2018 was lung cancer; it is also the leading cause of cancer death in Europe. We studied patient and tumor characteristics, and patterns of healthcare provision explaining regional variability in lung cancer survival in southern Spain. Methods A population-based cohort study included all 1196 incident…
Background Epidemiological studies suggest that haem iron, which is found predominantly in red meat and increases endogenous formation of carcinogenic N-nitroso compounds, may be positively associated with lung cancer. The objective was to examine the relationship between haem iron intake and lung cancer risk using detailed smoking history data and serum cotinine to control for…
Objective: To examine timing of eating across ten European countries. Design: Cross-sectional analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study using standardized 24 h diet recalls collected during 1995–2000. Eleven predefined food consumption occasions were assessed during the recall interview. We present time of consumption of meals and snacks as…
BACKGROUND: public health surveillance (PHS) of industrially contaminated sites (ICSs) is likely to play a role in supporting the monitoring of harmful aspects of ICSs and related interventions. Environmental public health tracking (EPHT) has been proposed and developed as an approach to PHS when environmental factors affecting health are involved. OBJECTIVES: to identify existing arrangements…
BACKGROUND: this paper is based upon work from COST Action ICSHNet. Health risks related to living close to industrially contaminated sites (ICSs) are a public concern. Toxicology-based risk assessment of single contaminants is the main approach to assess health risks, but epidemiological studies which investigate the relationships between exposure and health directly in the affected…
Childhood obesity continues to be a significant public health issue worldwide. Recent national studies in Spain show a stable picture. However, prevalence and trends differ by socio-economic status, age, and region. We present the trend in childhood excess weight prevalence, aged 8–15 years, in Andalusia from 2011-2012 to 2015–2016 by socio-economic status. Methods Using the cross-sectional…
La participación es un proceso que requiere la implicación de responsables de la política, del personal directivo y técnico de las instituciones, y de la ciudadanía, así como de la acción intersectorial e interdisciplinaria. Para generar cambios transformadores es necesaria una infraestructura que favorezca la participación y la acción planificada, reconociendo a todos los actores…
El término «salud comunitaria» es ampliamente utilizado en nuestro medio, con una recuperación progresiva de su interés en los últimos 10 años. Consideramos que, aunque muy difundido, se trata de un término impreciso, por lo que percibimos la necesidad y la pertinencia de una mejor definición operativa. Se realizó una revisión de la literatura especializada,…
Recently, we identified unique processing patterns of apolipoprotein A2 (ApoA2) in patients with pancreatic cancer. This study provides a first prospective evaluation of an ApoA2 isoform (“ApoA2‐ATQ/AT”), alone and in combination with carbohydrate antigen 19‐9 (CA19‐9), as an early detection biomarker for pancreatic cancer. We performed ELISA measurements of CA19‐9 and ApoA2‐ATQ/AT in 156 patients…
La incorporación de contenidos docentes relativos a la salud comunitaria en los programas formativos de enfermería y medicina contribuye a acrecentar la calidad, el rigor y la sostenibilidad de las intervenciones comunitarias. En este artículo dialogamos sobre cómo la medicina familiar y comunitaria y la atención primaria siguen sin ser consideradas disciplinas nucleares y transversales…
Cuatro voces repartidas por España dialogan sobre salud comunitaria y redes, entendiendo que estas son sistemas formados por personas interconectadas, con un interés común, que dan apoyo y sostén. Las redes requieren un espacio común y tiempo, para generar un clima de confianza y respeto que permita un trabajo horizontal. Así se consensua que son…
Fundamento. El objetivo de este estudio es determinar la efectividad de intervenciones no farmacológicas para la prevención de eventos relacionados con enfermedad cardiovascular (CVD), y mortalidad en adultos sanos o con alto riesgo de CVD. Método. Revisión de revisiones sobre prevención primaria de intervenciones no farmacológicas en las bases de datos de PubMed Health, Effective…
Research suggests that people are less sensitive to variations in probability in affect‐rich compared with affect‐poor risky choices. This effect is modeled by a more curved probability weighting function (PWF). We investigated the role of different numeric competencies and the effectiveness of several intervention strategies to decrease this affect‐laden probability distortion. In two experiments, we…
En los últimos años, los mapas de activos para la salud se están convirtiendo en herramientas cada vez más presentes en el ámbito de la promoción de la salud. Se están incorporando a la práctica diaria de muchos profesionales de la salud, tanto en la atención individualizada en las consultas (mediante la prescripción social) como…
Background Helping consumers make healthier food choices is a key issue for the prevention of cancer and other diseases. In many countries, political authorities are considering the implementation of a simplified labelling system to reflect the nutritional quality of food products. The Nutri-Score, a five-colour nutrition label, is derived from the Nutrient Profiling System of…
Insulin‐like growth factor (IGF‐I) regulates cell proliferation and apoptosis, and is thought to play a role in tumour development. Previous prospective studies have shown that higher circulating concentrations of IGF‐I are associated with a higher risk of cancers at specific sites, including breast and prostate. No prospective study has examined the association between circulating IGF‐I…
Pancreatic cancer (PC) has an exceptionally low survival rate and primary prevention strategies are limited. Folate plays an important role in one‐carbon metabolism and has been associated with the risk of several cancers, but not consistently with PC risk. We aimed to investigate the association between dietary folate intake and PC risk, using the standardised…
Background In 2015, following a call for proposals from the Special Programme for Research and Training in Tropical Diseases (TDR), six scoping reviews on the prevention and control of vector-borne diseases in urban areas were conducted. Those reviews provided a clear picture of the available knowledge and highlighted knowledge gaps, as well as needs and…
Background This paper presents the overall approach undertaken by the “VEctor boRne DiseAses Scoping reviews” (VERDAS) consortium in response to a call issued by the Vectors, Environment and Society unit of the Special Programme for Research and Training in Tropical Diseases hosted by the World Health Organization. The aim of the project was to undertake…
Background The control of vector-borne diseases (VBD) is one of the greatest challenges on the global health agenda. Rapid and uncontrolled urbanization has heightened the interest in addressing these challenges through an integrated vector management (IVM) approach. The aim was to identify components related to impacts, economic evaluation, and sustainability that might contribute to this…
This is a cross-sectional study of participants from a population census living in the province of Granada (Spain). A total of 1176 persons were contacted, 367 (31%) refused and 54 (6.7%) needed substitution. A final sample of 809 participants (response rate, 69.3%) were screened for mental disorder (MD) using the MINI International Neuropsychiatric Interview, a…
Las técnicas de generación de ideas han sido aplicadas como parte de la met
